Orchitis may be caused by numerous bacterial and viral organisms. It is usually a consequence of epididymitis, which is inflammation of the epididymis (the tube which connects the vas deferens and the testicle).
The most common viral cause of orchitis is mumps. Approximately 30 % of patients who have mumps will develop orchitis during the course of the illness. It is most common in post-pubertal boys (rare before 10 years of age). It usually manifests 4 to 6 days after the onset of mumps. In one-third of boys who get orchitis caused by mumps, testicular atrophy (shrinking of the testicles) will result.
For the bacterial causes, please refer to the epididymitis article. Of note, brucellosis is a rare disease in which orchitis develops in 2 to 20% of men with the disease.
Orchitis may also occur in conjunction with infections of the prostate or epididymis and, like those conditions, may occur as a manifestation of sexually-transmitted diseases such as gonorrhea or chlamydia. The incidence of sexually-transmitted orchitis or epididymitis is higher in men 19 to 35 years old.
Risk factors for non-sexually transmitted orchitis include:
- Inadequate immunization against mumps
- Older age (age greater than 45)
- Recurrent urinary tract infections
- Congenital abnormalities of the urinary tract
- Genito-urinary surgery/instrumentation
- Chronic indwelling urethral (Foley) catheter
Risk factors for sexually transmitted orchitis include:
- Multiple sexual partners
- Other high risk sexual behaviors.
- History of a sexual partner with a previously diagnosed STD
- Personal history of gonorrhea or other STD
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